What does SOAP stand for in clinical documentation?

• A. Subjective, Objective, Analysis, and Plan
• B. Subjective, Objective, Assessment, and Plan
• C. Systemic, Objective, Assessment, and Procedure
• D. Summary, Objective, Analysis, and Plan

Answer: (B)

In clinical notes, information is organized in four sections: Subjective data, Objective data, Assessment, and Plan. Subjective data are what the patient reports—symptoms, concerns, and history. Objective data are what the clinician can measure or observe—exam findings, test results, and vital signs. The Assessment is the clinician’s diagnosis or impression based on combining the subjective and objective information. The Plan outlines what will be done next—treatments, tests, referrals, patient education, and follow-up.

This structure corresponds exactly to Subjective, Objective, Assessment, and Plan, making it the correct choice. The other options mix terms that aren’t part of the standard SOAP format, such as Analysis, Systemic, Procedure, or Summary, which don’t represent the established sections of a SOAP note.